Making the most of supervised practice

Supervised practice is paramount to the teaching and learning of psychotherapy (Watkins, 1997). The novice therapist in a university training programme typically receives formal supervisory feedback at least once a week, and often benefits from additional ad hoc and informal guidance by readily available supervisors. After graduating, therapists move on to positions where their contracts stipulate and guarantee them the accumulation of a required minimum number of supervised practice hours for accreditation. Once accredited, however, supervision is often harder to come by. Recent reviews of clinical supervision in various mental health professions (Spence et al., 2001; Strong et al., 2003; Townend et al., 2002) concluded that the realities of high case loads, higher priority of crisis management, poor access to supervisors, and lack of clear policy guidelines are cited as reasons for many practitioners receiving little or infrequent supervision. For example, in a sample of 170 cognitive behavioural therapists in the UK, the mean number of supervision hours received was just over two hours per month for 52 hours of direct face-to-face client contact (Townend et al.). Thus, the intense level of supervision available during the initial training of psychotherapists is a time-limited privilege! Moreover, in a survey of over 4,000 psychotherapists with different professional backgrounds, career levels, theoretical orientations and nationalities, getting formal supervision was rated as the second most positive influence on their career development, after the experience of working directly with clients (Orlinsky et al., 2001).